Basic Information
| Provider Information | |||||||||
| NPI: | 1922192764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHERMAN | ||||||||
| FirstName: | NARDA | ||||||||
| MiddleName: | MELISSA | ||||||||
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| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16420 SE DIVISION STREET | ||||||||
| Address2: | PORTLAND METRO TREATMENT CENTER | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972361987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037623130 | ||||||||
| FaxNumber: | 5032887538 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 N GRAHAM ST | ||||||||
| Address2: | SUITE 555 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972271654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032887535 | ||||||||
| FaxNumber: | 5032887538 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 03/15/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | PA00799 | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363AM0700X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.